Northport Medical Center LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

749 Issued in MN

Legal business name

NORTHPORT MEDICAL CENTER LTD

Practice address

5415 Brooklyn Blvd
Brooklyn Center, MN 55429-3359

Phone

(763) 533-8666

Fax

(763) 533-8711

NPI assigned

Dec 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Duane L Orn, MD

Title

Owner

Phone

(763) 533-8666

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1174684336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293359",
            "telephone_number": "763-533-8666",
            "fax_number": "763-533-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293359",
            "telephone_number": "763-533-8666",
            "fax_number": "763-533-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT MEDICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "ORN",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-533-8666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.